Opinion: Maine stopped anti-trans bills this session, and advanced the fight for equality
By Quinn Gormley
If you’ve paid attention at all to LGBTQ+ politics over the last 12 months, you know that conservative politicians are obsessed with transgender people. In states across the country, and in Congress, hundreds of anti-trans and anti-queer bills have been proposed. These bills include initiatives to keep trans girls from playing on elementary soccer teams, to censoring books in our school and public libraries, to preventing research and education on issues of equity and inclusion, outing trans kids to their parents without their consent, and most often, making it harder, or even illegal, to affirm trans people’s identities and block our access to gender-affirming healthcare.
Maine was not immune to these attacks. Republicans proposed dozens of anti-trans and anti-queer bills this session. But with the help of pro-equality majorities in the legislature, every last one of them was soundly defeated.
Beating back bad bills is enough reason to celebrate, but it actually sells Maine short. Not only did we stop bad bills, we also passed a number of good ones, moving the fight for equality further down the road. Four of these pro-equality bills are first-in-the-nation pieces of legislation, meaning that once again Maine is leading the country on LGBTQ+ inclusion.
Protecting and expanding gender affirming care
The vast majority of anti-trans bills around the country right now are focused on banning gender affirming care (GAC). Though efforts to ban GAC began with preventing minors from accessing it, increasingly state legislators are adding provisions to prevent adults from accessing it as well. GAC is evidence-based, has been in use for nearly a century, and is supported by every major medical association in the country. Our top priority this legislative session was about protecting and expanding access to this vital, life-saving health care for generations to come.
LD 535 created a pathway to GAC for 16 and 17 year olds without parental consent
Despite the overwhelming consensus that GAC is safe and effective, it remains stigmatized. Unfortunately, many minors are denied access to this care by their parents who do not affirm who they are, or who are fearful of this care. Making young people wait until they are 18 to access this care is not a neutral act. Going through the wrong puberty can be deeply traumatizing and can lead to lifelong mental health struggles and suicide. Simply put, young people’s access to care shouldn’t depend on whether or not they were lucky enough to be born into a supportive family.
LD 535 makes it possible for some 16 and 17 year olds who meet specific criteria — including demonstrating sufficient capacity to consent to care, understanding potential side effects of GAC, and showing that they are or will experience harm if care is delayed — to be prescribed hormone therapies without parental consent.
LD 1040 protects gender affirming care coverage under MaineCare
In June of 2019, Gov. Janet Mill’s administration removed exclusions for GAC under MaineCare. At least 30% of trans Mainers rely on MaineCare for their healthcare, according to the 2021 Maine Transgender Community Survey, so this move represented the single largest expansion of GAC in Maine history. Because this change was done administratively, it remained vulnerable to changes under a future administration. LD 1040 put this coverage into statutory law, which means it will take an act of the legislature to remove this coverage in the future. This would likely require Republicans to gain complete control of state government, which has only happened once in the last 40 years.
Data collection is the pathway to equity
It’s not the most exciting topic, but data collection really matters for LGBTQ+ people, especially trans people. Inclusive data collection and proper documentation on vital record documents are essential to charting a pathway to equity, and to keeping trans people safe.
LD 956 ensures LGBTQ+ patients are asked the right questions
Did you know that among gay and queer men, 70% of gonorrhea infections go undiagnosed or are diagnosed at later stages of the disease when compared to straight men? This is because testing for gonorrhea requires swabbing in the right part of the body. Most providers, when testing men, only swab one area, and most gonorrhea infections in the bodies of men who have sex with men are in other areas. Did you know that trans women may need both prostate and breast cancer screening? Many providers don’t even know to ask. Asking simple questions about sexual orientation, the gender of sexual partners, and taking appropriate inventory of what body parts someone has are essential to ensuring providers are providing the right care for patients.
LD 956 makes Maine the first state in the U.S. to require health care facilities to collect data about sexual orientation and gender identity. The exact questions they ask will mirror national standards for this type of screening and will evolve over time as these standards get better. Though health care facilities are required to ask these questions whenever they ask for other demographic information (such as race, religion, occupation or age), patients are not required to answer them.
Maine health care facilities have three years to update their health record systems and practices to incorporate this new requirement.
LD 1503 ensures our vital records record who we are for future generations
LD 1503 completes a multi-year effort to update how trans people are documented on vital records. In 2020, Maine passed a law including gender marker X on birth certificates. LD 1503 adds this option to marriage certificates, and allows marriage certificates to be updated and reissued if one or both spouses transition. It also makes it possible for trans people to designate how they would like their sex recorded on their death certificate in their health records or advanced directive.
This might not seem like a huge victory, but it does two important things. Death certificates are how the state measures causes of death and informs our public health work. This change means Maine will be the first state to actually have quality data about mortality rates among transgender people. And though many people simply store their marriage certificates, they are a useful document for many LGBTQ+ couples to prove their legal relationships, which can be vital in moments of health crisis.
Ensuring state government respects and protects us
Maine has a long record of leading the country in LGBTQ+ protections, but our state government still has some areas of improvement.
LD 942 moves us closer to full legal recognition of nonbinary Mainers
Maine added gender marker X to state IDs in 2018, and to birth certificates in 2020. This was a huge victory for nonbinary inclusion. Gender affirming IDs have been shown to substantially reduce experiences of discrimination and violence for trans people. Unfortunately, our state government has yet to fully adapt to this change. The vast majority of state forms and databases (everything from tax documents, to MaineCare forms, to some hunting licenses) do not include options for gender marker X. LD 942 requires the administration to take inventory of all state forms, to add gender marker X wherever possible, remove gender fields where they are not needed, and to report back to the legislature in January on forms and databases that will require more time or funds to update.
This might sound simple, but updating state databases is made exponentially more challenging by our states out of date IT systems. Adding gender marker X to state IDs was delayed by the BMV needing to replace their entire database system. Our state HR systems were built in the late 90s in coding languages rarely used anymore. We hope this inventory will encourage the state to fully adapt to the 21st century, but we anticipate funding challenges in the short session next January to finish the job. Stay tuned for how you can support our efforts.
LD 489 will keep LGBTQ+ kids safer in schools and take controversy away from school boards
Controversy over trans inclusion has unfortunately been concentrated on kids and schools. Anti-trans activists have targeted more than a dozen school districts across the state and their school boards don’t have the tools they need to protect LGBTQ+ students. Although sexual orientation and gender identity are protected under the Maine Human Rights Act, which applies to public schools, the rules for how the MHRA is to be implemented in schools have not been updated in 20 years. In those 20 years, gender identity, sexual orientation, nationality and ethnicity were added as protected classes, but this isn’t reflected in the rules leaving school boards and administrators responsible for guessing at how to best protect all their students.
LD 489 requires the Maine Department of Education to finally update these rules, so schools across the state will have clear guidelines about how to protect the civil rights of all students, including LGBTQ+ students. We hope these clearer state guidelines will also reduce the focus on school boards, because civil rights issues should never be left up to local control.
